Study on the effect of AIDS preventive cascade services provided by social organizations for men who have sex with men in China

Abstract

Objective: To analyze the effect and main gaps of each stage in the AIDS prevention cascade for men who have sex with men (MSM) provided in intervention projects supported by the China AIDS Fund for non-governmental organizations (CAFNGO) and provide suggestions to improve the quality of cascade services and project management. Methods: Data were collected through the CAFNGO management information system and field interviews to analyze the differences in the number of MSM receiving HIV testing and confirming tests, the newly reported patients, and the number of antiviral treatment (ART) referrals of newly established reported patients among different social organization service areas. A service chain chart was also drawn. Results: Between 2016 and 2020, 1 508 MSM intervention projects were funded by CAFNGO, including 1 183 234 MSM being mobilized to receive HIV testing. However, only 68.8% (1 183 234/1 719 139) of the testing capacity of social organizations was covered by these projects. As a result, 55 783 HIV-positive MSM were detected in preliminary screening, and only 86.6% (48 327/55 783) received confirming tests. The proportion of newly reported infections was 3.8% (45 347/1 183 234). The ratio of antiviral treatment (ART) referrals for newly reported patients between 2017 and 2020 was 89.8% (32 719/36 444). 75.8%(1 143/1 508) of total MSM intervention projects were implemented by community-based organizations (Non-registered civil affairs departments). In comparison, organizations registered in civil affairs departments took up 24.2% (365/1 508) of the total MSM intervention projects. No significant difference was noticed in the proportion of newly reported infected (3.8% and 3.8%) and the ratio of ART referrals (89.7% and 89.9%) between community-based organizations and registered organizations' projects. But these two proportions are significantly different between these two types of organizations in some areas in China. Conclusions: The AIDS prevention cascade established in CAFNGO has effectively promoted the early detection and treatment of infected MSM. However, CAFNGO needs more financial support to extend testing coverage for MSM. Meanwhile, confirmation testing for positives in preliminary screening and ART referrals needs to be improved for newly reported patients. In addition, various capacity building needs to be provided for different social organizations.